[Advanced gastric cancer: the findings of delayed phase dynamic CT and radiologic-histopathologic correlation].

PURPOSE: The aim of this study was to describe delayed phase dynamic CT findings of advanced (T2-T4) gastric cancer and to correlate with histopathologic findings. METHOD/MATERIALS: Quadruple phase dynamic CT including delayed imaging taken five minutes after the start of injection of contrast material was performed in 43 patients with 45 advanced gastric cancer and 20 control subjects with no gastric lesions. On delayed phase CT scans, the attenuation of the gastric wall was equal to or lower than that of the liver parenchyma in the control subjects, therefore, the presence of higher attenuation in the gastric wall was considered to be abnormal and defined as delayed enhancement. Histopathologic findings in the tumors showing delayed enhancement were compared with those in the tumors without this feature. RESULTS: Delayed enhancement was seen in 26 (57%) of the 45 tumors. Eleven of 25 differentiated-type tumors and 15 of 20 undifferentiated-type tumors showed delayed enhancement (P < .05). Delayed enhancement was seen in one of five medullary type tumors, in 11 of 25 intermediate-type tumors, and in 14 of 15 scirrhous-type tumors (P < .005). CONCLUSIONS: Delayed enhancement was frequently seen in the tumors with abundant fibrous tissue stroma. Delayed phase dynamic CT may be useful for the characterization of advanced gastric cancer.

Requirement of CD80 and CD86 molecules for antigen presentation by eosinophils.

The authors analysed the antigen-presenting ability of eosinophils purified from peritoneal exudate cells of interleukin-5 (IL-5) transgenic mice. The granulocyte-macrophage colony-stimulating factor (GM-CSF)-treated eosinophils induced proliferative responses of primed lymph node T cells and thymus T cells to staphylococcal enterotoxin B (SEB), while untreated eosinophils induced little or no response. GM-CSF-treated eosinophils also induced proliferation of ovalbumin (OVA)-primed lymph node T cells to OVA. Although untreated eosinophils expressed no MHC class II molecule on the surface the eosinophils could be induced to express major histocompatibility complex (MHC) class II molecules when treated with GM-CSF. In the present study, anti-I-Ak monoclonal antibodies (MoAbs) strongly inhibited proliferation of thymus T cells and proliferation of OVA-primed lymph node T cells in response to OVA, but weakly inhibited proliferation of primed T cells in response to SEB. Furthermore, CD80 (B7-1) and CD86 (B7-2) were expressed on the surfaces of untreated eosinophils. The expression of those two molecules on the eosinophils was increased by incubation with GM-CSF. Moreover, anti-CD80 or anti-CD86 MoAbs blocked proliferative responses of primed lymph node T cells and thymus T cells to SEB, and also blocked responses of primed lymph node T cells to OVA. Thus, CD80 and CD86 play an important role in stimulation of T cells by eosinophils.

Vulvar dystrophy: a clinical follow-up.

The vulvar dystrophy is an enigma and one of the most controversial topic as for the pathogenesis, clinical outcome and particularly the malignant potentiality. There has been very few systematic studies regarding vulvar dystrophy in Japan. Vulvar dystrophy with dysplasia is said to be a pre-malignant condition of the vulva. So in our institute a prospective follow-up of 5 months to 4 years was obtained in vulvar dystrophic patients after a conservative protocol of treatment. The initial histological diagnosis revealed 17 patients with squamous hyperplasia (9 patients with dysplasia and 8, without dysplasia), lichen sclerosus in 5 and other dermatoses in 1 patient. "Itching" was the most frequent complaint, encountered in 20 (69%) of the study patient. Amongst these patients 4/5 of lichen sclerosus and 16/18 of squamous hyperplasia and other dermatoses had complete symptomatic relief with testosterone and corticosteroid respectively. Morphologically 22/23 (96%) had more than 50% decrease of the total lesion. In squamous hyperplasia with dysplasia after treatment, the re-biopsy revealed improvement of the dysplasia in all the cases with total disappearance in the mild dysplasia group. So far, vulvar carcinoma did not develop in any of the patient followed in our study who received treatment for vulvar dystrophy. So, for vulvar dystrophy, a benign squamous epithelial disorder of the vulva, steroid hormone therapy is indeed a logical and a consistent one.

[Analysis of 7 cases with intracavernous aneurysm].

Intracavernous sinus aneurysm is rare and consists of approximately 3% of intracranial aneurysm. Since this aneurysm increases gradually in size and causes various neurological signs, differential diagnosis is necessary. In this report, seven cases of intracavernous sinus aneurysm were analyzed. In conclusion, oculomotor or abducens nerve palsy were seen in most cases. Though trigeminal nerve palsy was suspected in many cases, it was actually seen only in one case. Most cases developed slowly and progressively. One case showed an acute onset and the differential diagnosis from internal carotid-posterior communicating aneurysm was needed. To diagnose intracavernous sinus aneurysm, computed tomography scan was very valuable.

Computed tomography of ovarian masses.

A retrospective analysis of CT images in 138 histologically proven ovarian masses in 100 patients was undertaken to evaluate the usefulness and limitation of CT in the diagnosis of ovarian tumors. Benign masses were purely cystic in 98 (94.2%) and had solid component (including thickened walls, thickened septa, papillary projections) in five of 104 lesions (4.8%) on CT. These five masses, which are classified as benign solid tumors, could not be differentiated from malignant tumors by either the size of the solid portion or the intensity of contrast enhancement. In the malignant tumors a solid portion was detected in 32 of 34 tumors (94%). When a solid component is detected in an ovarian mass, the mass should be considered malignant although a few cases will be benign solid tumors. In Krukenberg tumors, which were all of gastric origin, the solid component was so large that it occupied more than one-half the mass. Therefore, if the solid portion of the ovarian mass is large on CT, upper gastrointestinal study should be performed to rule out Krukenberg tumor.

Abnormally high diffuse activity on bone scintigram. The importance of exposure time for its recognition.

When the bone scintigram reveals high diffuse skeletal activity, it may be misinterpreted as normal. Some authors have reported such scintigrams in articles entitled "Significance of absent or faint kidney sign on bone scan" and "False negative bone scintigram". Three cases with bone metastasis showing high diffuse skeletal activity are presented in this paper. The recognition of abnormally high diffuse skeletal activity on bone scintigrams is discussed. The exposure time of all three cases was short when compared with normal cases, when the bone image was taken with a preset count. Therefore, exposure time is very important for objective differentiation between the cases showing high diffuse skeletal activity and normal cases.